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A group of about 150 physician groups sent a letter both commending and criticizing the Trump administration's planned changes in the 2019 physician fee schedule.

A letter sent Monday to Centers for Medicare & Medicaid Services Administrator Seema Verma concludes with a long list of physician groups that signed onto the message both praising CMS and questioning the wisdom of certain payment policy changes planned by the agency.

The letter, released by the American Medical Association (AMA), says doctors believe CMS listened to their concerns about the administrative burdens of evaluation and management (E/M) documentation requirements.

"Excessive E/M documentation requirements do not just take time away from patient care; they also make it more difficult to locate medical information in patients' records that is necessary to provide high quality care," it continues. "Physicians and other health care professionals are extremely frustrated by 'note bloat,' with pages and pages of redundant information that makes it difficult to quickly find important information about the patient’s present illness or most recent test results."

The letter comes in response to the proposed physician fee schedule for 2019, which the agency unveiled last month. In addition to the streamlined E/M documentation, the proposal would reduce the number of levels for paperwork and payment—a change that quickly met opposition.

With regard to the proposed payment structure, the letter from the AMA and other physician groups raised concerns about "a number of unanswered questions and potential unintended consequences."

"We oppose the implementation of this proposal because it could hurt physicians and other health care professionals in specialties that treat the sickest patients, as well as those who provide comprehensive primary care, ultimately jeopardizing patients' access to care," the letter states.